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    <td height="25" valign="top" class="ytitle">Promoter tilmelding</td>
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if (!$reg_succeed) {
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  <form action="" method="post" name="form1" onSubmit="return checkPromoterRegForm(form1);">
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    <td align="left" valign="top" >
      <table width="100%"  border="0" cellspacing="2" cellpadding="0">
        <tr>
          <td height="30" >Felter markeret med * skal udfyldes.</td>
        </tr>
      </table>
      <table width="100%"  border="0" cellspacing="2" cellpadding="0">
        <tr>
          <td width="165" >Firma :</td>
          <td><input name="company" type="text" id="company" style="width:195px"></td>
        </tr>
        <tr>
          <td >Fornavn* :</td>
          <td><input name="firstname" type="text" id="firstname" style="width:195px"></td>
        </tr>
        <tr>
          <td >Efternavn* :</td>
          <td><input name="lastname" type="text" id="lastname" style="width:195px"></td>
        </tr>
        <tr>
          <td >Adresse* :</td>
          <td><!--input name="address" type="text" id="address" style="width:350px"--></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Gade/ husnr./ etage :</td>
          <td><input name="street" type="text" id="street" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>By :</td>
          <td><input name="city" type="text" id="city" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Amt :</td>
          <td><input name="state" type="text" id="state" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Postnummer :</td>
          <td><input name="zip" type="text" id="zip" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Land :</td>
          <td><input name="country" type="text" id="country" style="width:195px"></td>
        </tr>
        <tr>
          <td >&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td >Leveringsadresse
            :</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Gade/ husnr./ etage :</td>
          <td><input name="street2" type="text" id="street2" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>By :</td>
          <td><input name="city2" type="text" id="city2" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Amt :</td>
          <td><input name="state2" type="text" id="state2" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Postnummer :</td>
          <td><input name="zip2" type="text" id="zip2" style="width:195px"></td>
        </tr>
        <tr>
          <td ><span style="width:40px;">&nbsp;</span>Land :</td>
          <td><input name="country2" type="text" id="country2" style="width:195px"></td>
        </tr>
        <tr>
          <td >&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td >Telefon* :</td>
          <td><input name="phone1" type="text" id="phone1" style="width:40px">
            <input name="phone" type="text" id="phone" style="width:149px"></td>
        </tr>
        <tr>
          <td >Mobil :</td>
          <td><input name="mobile1" type="text" id="mobile1" style="width:40px">
            <input name="mobile" type="text" id="mobile" style="width:149px"></td>
        </tr>
        <tr>
          <td >Fax :</td>
          <td><input name="fax1" type="text" id="fax1" style="width:40px">
            <input name="fax" type="text" id="fax" style="width:149px"></td>
        </tr>
        <tr>
          <td >Email* :</td>
          <td><input name="email" type="text" id="email" style="width:195px"></td>
        </tr>
        <tr>
          <td >Web side :</td>
          <td><input name="website" type="text" id="website" style="width:195px" value="http://"></td>
        </tr>
        <tr>
          <td >&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td height="30" class="title03">Bankinformation :</td>
          <td >&nbsp;</td>
        </tr>
        <tr>
          <td >Bank :</td>
          <td ><input name="bank" type="text" id="bank" style="width:195px"></td>
        </tr>
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          <td >Registreringsnummer :</td>
          <td ><input name="registration" type="text" id="registration" style="width:195px"></td>
        </tr>
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          <td >Kontonummer :</td>
          <td ><input name="account" type="text" id="account" style="width:195px"></td>
        </tr>
        <tr>
          <td >IBAN kode :</td>
          <td ><input name="iban" type="text" id="iban" style="width:195px"></td>
        </tr>
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          <td >SWIFT kode :</td>
          <td ><input name="swift" type="text" id="swift" style="width:195px"></td>
        </tr>
        <tr>
          <td>&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
      </table>
      <table width="100%"  border="0" cellspacing="2" cellpadding="0">
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          <td height="30" class="title03">Promoter provision :</td>
          <td>&nbsp;</td>
        </tr>
        <tr>
          <td width="95%" align="left" valign="top" >Jeg nsker trning / produkter mod provision<br>
            <span class="littlefont02">Nr du vlger produkter og eller kurser / trning hos Acuity World mod provisionsbetaling, fordobler vi din provision.</span> </td>
          <td width="5%" align="center" valign="top"><input name="faq1" type="radio" class="inputimage" id="q1" value="1" checked="checked"></td>
        </tr>
        <tr>
          <td height="8" align="left" valign="top" ></td>
          <td align="center" valign="top"></td>
        </tr>
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          <td align="left" valign="top" >Jeg nsker min provision sat ind p min bankkonto. 
            &nbsp;&nbsp;&nbsp;<a href="promoter_settlement_dates.php" target="_blank"><font color="#0000FF"><u>Link til afregningsdatoer</u></font></a></td>
          <td align="center" valign="top"><input name="faq1" type="radio" class="inputimage" id="q1" value="0"></td>
        </tr>
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          <td align="left" valign="top" >Ja, jeg har lst og accepteret Acuity Worlds standardaftale for promotere  <a href="general_promoter_agreement.php" target="_blank"><font color="#0000FF"><u>Link til standardaftale for promotere</u></font></a></td>
          <td align="center" valign="top"><input name="faq3" type="checkbox" class="inputimage" id="q3" value="1" checked="checked"></td>
        </tr>
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          <td align="left" valign="top" >Ja, jeg har lst og accepterer Acuity World WebShop <a href="delivery_policy.php" target="_blank"><font color="#0000FF"><u>Salgs- og leveringsbetingelser</u></font></a></td>
          <td align="center" valign="top"><input name="faq4" type="checkbox" class="inputimage" id="q4" value="1" checked="checked"></td>
        </tr>
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          <td align="left" valign="top" >Ja tak, jeg vil gerne optages p Acuity Worlds <a href="promoter_list.php" target="_blank"><font color="#0000FF"><u>promoterliste</u></font></a></td>
          <td align="center" valign="top"><input name="faq5" type="checkbox" class="inputimage" id="q5" value="1" checked="checked"></td>
        </tr>
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          <td align="left" valign="top" >Ja tak, jeg vil gerne have et link til min web side fra Acuity World WebShops website</td>
          <td align="center" valign="top"><input name="faq6" type="checkbox" class="inputimage" id="q6" value="1" checked="checked"></td>
        </tr>
        <tr>
          <td align="left" valign="top" >Ja tak, jeg vil gerne have tilsendt et banner til opstning p min web side<br>
            <span class="littlefont02">Dette vil sikre, at dit promoternummer automatisk registreres for de personer, der er henvist fra dig.</span></td>
          <td align="center" valign="top"><input name="faq7" type="checkbox" class="inputimage" id="q7" value="1" checked="checked"></td>
        </tr>
        <tr>
          <td height="8" align="left" valign="top" ></td>
          <td align="center" valign="top"></td>
        </tr>
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          <td align="left" valign="top" >Ja tak, jeg vil gerne modtage Acuity Worlds nyhedsbrev</td>
          <td align="center" valign="top"><input name="faq8" type="checkbox" class="inputimage" id="q8" value="1" checked></td>
        </tr>
        <tr>
          <td height="30" >&nbsp;</td>
          <td>&nbsp;</td>
        </tr>
      </table>
    </td>
  </tr>
  
  <tr>
    <td>
    <table width="100%" height="30"  border="0" cellpadding="0" cellspacing="1">
      <tr>
        <td align="left" valign="top" class="bluefoni">		Ligesom promoter til enhver tid kan ophve denne aftale, forbeholder Acuity World sig ret til, at opsige denne <a href="general_promoter_agreement.php" target="_blank"><font color="#0000FF"><u>aftale</u></font></a> uden varsel.</td>
      </tr>
      <tr>
        <td height="30">&nbsp;</td>
      </tr>
    </table>
    <table width="100%"  border="0" cellspacing="5" cellpadding="0">
      <tr>
        <td width="58%" align="right"><input name="join_submit" type="submit" class="inputbt" value="Indsend">
        </td>
        <td width="24%" align="right">&nbsp;</td>
        <td width="18%" align="left">&nbsp;</td>
      </tr>
    </table>
    </td>
  </tr>
                        
                        
                        
                        
  <input type=hidden name=act value="pregister">
  </form>
  
<!--
EOT;
} else {
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  <tr>
    <td height="60" align="left" valign="top" >Tak for din Promoter ansgning. Vi vil vende tilbage til dig, nr vi har overvejet din ansgning  indenfor 1  2 uger.                                           
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    <td height="30" align="left" valign="top" class="title03">Du har valgt flgende:  </tr>
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    <td align="left" valign="top" class="bluefont">
      <ul style="line-height:25px">
        {$alert_msg}
      </ul>
    </td>
  </tr>  


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</td>
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